RESUMO
The authors present a case of post-traumatic tension pneumocephalus of delayed onset. A 23-year-old man fell down and was admitted to our hospital with initial diagnosis of basal skull fracture associated with small amounts of pneumocephalus on brain computerized tomography(CT). At admission, the consciousness was alert without focal neurological deficit. During conservative therapy, headache was slowly progressive and consciousness became drowsy on 13th day after admission. The brain follow-up CT showed huge low air density lesion in the right frontal area. We performed unilateral subfrontal craniotomy with duroplasty for removal of air and dural repair with galea aponeurotica and abdominal fat. Postoperatively, the condition was recovered.
Assuntos
Humanos , Adulto Jovem , Gordura Abdominal , Encéfalo , Estado de Consciência , Traumatismos Craniocerebrais , Craniotomia , Diagnóstico , Seguimentos , Cefaleia , Pneumocefalia , Fraturas CranianasRESUMO
The intraspinal extradural meningeal cyst is a rare cause of compression of spinal cord. The most common clinical presentation is a slowly progressive myelopathy, but our case was presented with polyradiculopathy at admission. The authors believe that our case is particularly attributable to a ball-valve mechanism involving an idiopathic dural rent and a herniated segment of an underlying dorsal rootlet in the operative finding. As in our case, magnetic resonance imaging provides accurate diagnosis to identify an intraspinal extradural meningeal cyst. Closure of dural rent with marsupialization of the meningeal cyst through minimal laminectomy can be successfully managed with favorable clinical outcome as in our case.